Nude male, photographer unknown, c.1925, gelatin silver print. Collection of The Kinsey Institute for Research in Sex, Gender and Reproduction.

Men defy stereotypes in defining masculinity. Contrary to stereotypes about sexual performance and masculinity, men interviewed in a large international study reported that being seen as honorable, self-reliant and respected was more important to their idea of masculinity than being seen as attractive, sexually active or successful with women. The study published in the Journal of Sexual Medicine included interviews with more than 27,000 randomly selected men from eight countries (Germany, U.S., U.K., Spain, Brazil, Mexico, Italy and France), with about 16 percent of the men reporting erectile problems. Regardless of age or nationality, the men more frequently ranked good health, harmonious family life and good relationships with their wife or partner as more important to their quality of life than material, self-fulfilling or purely sexual concerns. There was no significant difference in rankings of masculinity and quality of life characteristics between men who experienced erectile dysfunction and those who did not. The study, part of the Men's Attitudes to Life Events and Sexuality (MALES) project, aimed to determine characteristics of masculinity and quality of life in men with and without self-reported erectile dysfunction, and how those ideas of masculinity might affect seeking help and treatment. "Many meanings, positive and negative, are attached to the term, 'masculinity,'" said Julia Heiman, director of The Kinsey Institute at Indiana University and an author of this study. "To ask a large sample of men what comprises their own sense of masculinity is very useful for both the media and for research. These results suggest we should pay attention and ask rather than presume we know."

Overall, being seen as honorable was considered the most important quality in the construct of masculinity.

Compared to men without erectile dysfunction, the experience of erectile dysfunction neither increased nor decreased the importance men placed on having an active sex life or having success with women, although men with erectile dysfunction reported less satisfaction with their sex lives.

Men who seek treatment for erectile dysfunction do not differ in their views of masculinity from those who do not seek help.

"Being seen as a man of honor" was cited as the most important attribute of masculine identity in Spain, Brazil, Mexico, United States and France, while "being in control of your own life" was the most important in Germany, the United Kingdom and Italy.

The findings emphasize that men across cultures and ages value couple relationships over purely sexual pleasure and indicate that men are particularly concerned about their partnered relationships, whether or not they report erectile dysfunction.

Co-authors include lead author Michael S. Sand, Boehringer-Ingelheim Pharma. Inc., Ridgefield, Conn.; William Fisher, University of Western Ontario, London, Ontario, Canada; Raymond Rosen, New England Research Institutes, Watertown, Mass.; and Ian Eardley, M.D., St. James's University Hospital, Leeds, United Kingdom.

Dysfunction and Constructs of Masculinity and Quality of Life in the Multinational Men's Attitudes to Life Events and Sexuality (MALES) Study. Journal of Sexual Medicine, 5 (3): 583-594

Emotional fitness. If the prospect of six-pack abs or weightloss is not enough to get you into the gym, how about feelings of calmness or heightened feelings of energy? Light to moderate aerobic exercise can improve mood for two to four hours following the activity. "These same positive benefits apply to children," said Indiana University psychologist Jack Raglin. "At the same time, it's becoming more and more challenging to find time for kids to have physical activity. Kids are overly scheduled -- parents have to work at finding avenues for activity." Raglin, a professor in IU's School of Health, Physical Education and Recreation, has conducted research examining overtraining syndrome, meditation and other issues involving mood and exercise. His studies and others have found the following:

Aerobic v. anaerobic. People are more likely to experience the mood-boosting benefits after aerobic activities such as jogging, lap swimming or cycling, compared to activities such as strength training.

Taking it easy. Far from huffing and puffing, the benefits can be experienced after just 20 minutes of light or moderate activity, such as a slow jog.

A pass for the cheerful? People who are clinically depressed experience the most mood-boosting benefits but Raglin said people who generally already are relaxed, with low levels of depression or anxiety, can still experience the feelings of calmness, lowered levels of anxiety and less fatigue.

Hard workouts. Intense workouts can bring about elevated feelings of anxiety and other unpleasant feelings immediately following the activity, Raglin said, but within five to 10 minutes these feelings usually are replaced with the longer-lasting positive feelings.

More is not better. Intense exercise routines, Raglin said, can cause depression in otherwise healthy individuals. Overtraining or staleness syndrome is a particular concern for serious endurance athletes, such as swimmers or runners, with roughly 10 percent of these athletes experiencing the syndrome over the course of one year of training -- and this rate increases significantly after five years of training. Staleness is associated with a long list of symptoms that include medical illnesses, such as infectious disorders, and psychological disturbances, depression in particular, that are far more severe than typical daily stresses. Raglin's studies have seen increasing levels of staleness syndrome among middle school and high school athletes. "Exercise is a complex stimulus," he said.

While more studies are pointing to the mental health benefits of exercise, Raglin said little is known about why it can have this effect. He said there is no evidence that endorphins are behind it, despite popular belief. It could be a combination of factors, ranging from warmer body temperatures affecting the brain's metabolism to the fact that when people exercise, they're taking a break from the normal stresses of the day.

Athletes who wear protective gear need to be particularly vigilant during hot-weather training.

Heat illness and athletes. Heat related injuries are of particular concern for athletes training in late summer and early fall as much of the country faces hot and humid conditions. Athletes who wear protective gear, such as football players, need to be particularly vigilant during hot-weather training. Dehydration and heat illness, both major causes of exercise associated collapse, are two of the most common and preventable forms of heat-related injuries. Exercise associated collapse is defined as an inability to walk unassisted. "Basically, it's when an athlete passes out or nearly passes out during or soon after exercise," said Meena Garg, M.D., assistant professor of Clinical Family Medicine at the Indiana University Center for Sports Medicine. "There is something going on that prevents an athlete from sustaining an upright position." There are a variety of reasons why a person could collapse during or soon after exercise, some more serious than others. "Common -- yet still concerning -- reasons include things like minor dehydration, muscle cramps and postural hypotension," Garg said. "More worrisome conditions include worsening heat illness, hypoglycemia, low sodium and heart related issues. These can have major health implications including death." Still, Garg warns that none of these issues should be taken lightly -- they can easily progress into something more serious.

It's important for athletes, parents and coaches to know the warning signs for heat illness:

Early heat illness. This can include symptoms such as muscle cramps and dry mouth. "People need to seek water, shade and rest," Garg said. "At this point we need to prevent people from going further into the spectrum of heat illness. Stretch, drink water or sports drinks. If a person is wearing any type of equipment, take it off."

Heat exhaustion. Further along the spectrum, heat exhaustion is more serious. Individuals might feel light-headed and experience nausea or headaches. Garg recommends taking the same steps as in early heat illness as well as placing cool water bottles or ice packs on parts of the body with major arteries such as the neck, armpits and groin.

Heat stroke. The third stage, heat stroke, can lead to death. Individuals experience all of the symptoms as in the previous two stages, but may also become confused and disoriented. They may also stop sweating. "After you call 911, immediately immerse the person in a tub of cold water and ice," Garg said. "Don't wait to pull off equipment, just plunge the person right in."

Garg said the best way to deal with heat illness is to prevent it. She offers the following tips:

Stay hydrated. Dehydration is one of the main contributors to heat illness. "By the time someone is thirsty they are already dehydrated," Garg said. "Take frequent breaks and put water bottles in the shade and get out of the sun." Generally, Garg recommends four to six ounces of water every 15 minutes of activity. Depending on the humidity and temperature, athletes may need more water. If exercising for longer than an hour, it's important to add a sports drink.

Change practice times. "In some counties coaches will schedule early morning and late evening practices to avoid practicing between the hot hours of 11 and three," said Garg.

Ease into hot-weather workouts. "If a person has been training indoors or in cooler weather, I recommend a seven- to 10-day acclimatization period before going into harder training outdoors in the heat," Garg said. She recommends gradually increasing light activity during that period.